Healthcare Provider Details

I. General information

NPI: 1528785979
Provider Name (Legal Business Name): KINTZ CONSULTING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/26/2022
Last Update Date: 10/26/2022
Certification Date: 10/26/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

330 FIEDLER AVE STE 103
DILLON CO
80435-5799
US

IV. Provider business mailing address

120 COVE BLVD UNIT 201
DILLON CO
80435-8812
US

V. Phone/Fax

Practice location:
  • Phone: 970-389-8969
  • Fax:
Mailing address:
  • Phone: 970-389-8969
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: JEANETTE LOUISE KINTZ
Title or Position: OWNER
Credential: M.A.
Phone: 970-389-8969